<html>
<head>
</head>
<body>
<form action="process.php" method="post">
Username : <input type="text" name="username" value ="" /> <br/>
Password : <input type="password" name ="password" value ="" /> <br/>
Enter password again : <input type="password" name="password2" value ="" /> <br/>
First Name : <input type="text" name="fname" value ="" /> <br/>
Last Name : <input type="text" name="lname" value ="" /> <br/>
SSN : <input type="text" name="ssn" value ="" /> <br/>
Email : <input type="text" name="email" value ="" /> <br/>
Phone : <input type="text" name="phone" value ="" /> <br/>
<input type="submit" name ="submit" value="Submit" />
</form>
</body>
</html>